PICaSSO Virtual Electronic Chromendoscopy Accurately Reflects Combined Endoscopic and Histological Assessment for Prediction of Clinical Outcomes in Ulcerative Colitis.
United European Gastroenterology journal(2022)
摘要
AbstractBackground and AimsA composite endoscopic‐histologic remission is increasingly explored as an important endpoint in ulcerative colitis (UC). We investigated combined endoscopic‐histologic remission for predicting clinical outcomes at 12 months compared with endoscopic remission alone using the high definition virtual chromoendoscopy (VCE) Paddington International virtual ChromoendoScopy ScOre (PICaSSO) and histology scores.MethodsUlcerative colitis patients, prospectively enrolled from 11 international centres, underwent VCE with targeted biopsies and followed up for 12 months. Endoscopic activity was assessed by Mayo Endoscopic Score (MES), Ulcerative Colitis Endoscopic Index Severity (UCEIS) followed by VCE‐PICaSSO. Robarts Histopathological Index|Robarts Histological index≤3 without neutrophils in mucosa, and Nancy Histological index (NHI)≤ 1 were used to define histologic remission. Combined endoscopic‐histologic remission was compared with endoscopic remission alone by Cox proportional hazards model and by two‐ and three‐proportion analysis using pre‐specified clinical outcomes.Results307 patients were recruited and 302 analysed. There was no difference in survival without specified clinical outcomes between PICaSSO defined endoscopic remission alone and endoscopic plus histologic remission in the rectum (HR 0.42, 95%CI 0.16‐1.11 and HR 1.03, 95%CI 0.42‐2.52 for Robarts Histological index and NHI respectively) at 12 months. There was however a significant survival advantage without specified clinical outcome events for UCEIS combined with histology compared with UCEIS alone (HR 0.30, 95%CI 0.12‐0.75, p = 0.02) at 12 months (but not combined with NHI). For MES there was no advantage for predicting specified clinical outcomes at 12 months for endoscopy alone versus endoscopy plus histology, but there were differences in two and three proportion analysis at 6 months.ConclusionEndoscopic remission by VCE‐PICaSSO alone was similar to combined endoscopic and histologic remission for predicting specified clinical outcomes at 12 months. Larger studies with specific therapeutic interventions are required to further confirm the findings.
更多查看译文
关键词
endoscopic remission,histological remission,mucosal healing,ulcerative colitis,virtual electronic chromoendoscopy,PICaSSO,clinical outcomes,prediction
AI 理解论文
溯源树
样例
![](https://originalfileserver.aminer.cn/sys/aminer/pubs/mrt_preview.jpeg)
生成溯源树,研究论文发展脉络
Chat Paper
正在生成论文摘要